Giudici Alessandro, Grillo Andrea, Scalise Filippo, Reesink Koen D, Delhaas Tammo, Salvi Paolo, Spronck Bart, Parati Gianfranco
Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM).
GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands.
J Hypertens. 2025 Apr 1;43(4):589-597. doi: 10.1097/HJH.0000000000003935. Epub 2025 Feb 7.
Aortic pulse wave velocity (aPWV) predicts cardiovascular risk. Being the reference method for aortic stiffness evaluation, invasive aPWV is also recommended for validation of noninvasive devices. Because of intrinsic haemodynamic variability and processing issues, aPWV shows beat-to-beat variability. We aimed to quantify this variability and evaluate its implications for the reliability and use of aPWV as reference in validation and clinical application studies.
The study included n = 84 patients, in whom two datasets of invasive data were recorded: 1) simultaneous ascending aorta and iliac pressure acquisitions using a dual-tip intra-aortic catheter, and 2) an additional ascending aorta pressure acquisition. By combining the iliac and ascending aorta pressure recordings from the first and second acquisitions, respectively, we evaluated how a sequential acquisition protocol affects variability. We compared three pressure waveform foot identification methods to investigate the effect of data processing on variability. Furthermore, we estimated how averaging over nbeats consecutive heartbeats affects the standard deviation (SD) of such nbeats -averaged estimate of aPWV.
The simultaneously acquired invasive aPWV showed a 5% beat-to-beat SD (variability), with small but significant differences between foot identification methods. The sequential acquisition protocol doubled aPWV variability compared to simultaneous acquisition. However, because averaging had a much stronger effect on sequentially measured aPWV, the two acquisition protocols yielded comparable variabilities at nbeats = 10 (2% vs. 3%).
Our study suggests that, independently from the acquisition protocol and data processing, the intrinsic beat-to-beat variability of aPWV becomes manageable when aPWV values of at least ten heartbeats are averaged.
主动脉脉搏波速度（aPWV）可预测心血管风险。作为评估主动脉僵硬度的参考方法，有创aPWV也被推荐用于验证无创设备。由于存在内在血流动力学变异性和处理问题，aPWV表现出逐搏变异性。我们旨在量化这种变异性，并评估其对aPWV在验证和临床应用研究中作为参考的可靠性和使用的影响。
该研究纳入了n = 84例患者，记录了两个有创数据集：1）使用双尖端主动脉内导管同时采集升主动脉和髂动脉压力；2）额外采集一次升主动脉压力。通过分别结合第一次和第二次采集的髂动脉和升主动脉压力记录，我们评估了顺序采集方案如何影响变异性。我们比较了三种压力波形足部识别方法，以研究数据处理对变异性的影响。此外，我们估计了对n个连续心跳进行平均如何影响这种n个心跳平均估计的aPWV的标准差（SD）。
同时采集的有创aPWV显示出5%的逐搏标准差（变异性），足部识别方法之间存在小但显著的差异。与同时采集相比，顺序采集方案使aPWV变异性增加了一倍。然而，由于平均对顺序测量的aPWV有更强的影响，两种采集方案在n = 10时产生了相当的变异性（2%对3%）。
我们的研究表明，与采集方案和数据处理无关，当对至少十个心跳的aPWV值进行平均时，aPWV固有的逐搏变异性变得可控。
